Researchers at the Medical University of South Carolina have made a promising discovery that could improve how we manage pain after surgery — and reduce the need for addictive opioid medications.
Their study found that a drug called N-acetylcysteine (NAC), already approved by the FDA for other uses, may help patients feel less pain after surgery and use fewer opioids during recovery.
This is an important step forward, as opioids are commonly used after surgeries but come with serious risks. While they are effective in reducing pain, they can lead to dependence, addiction, and unpleasant side effects. Over time, they may also stop working as well, leaving patients with limited options.
What Is NAC?
NAC is not a new drug. It’s typically used to treat acetaminophen (Tylenol) overdoses and liver damage, and it’s been around for years. But recent studies have shown that NAC also affects brain activity — especially in areas that deal with pain and addiction.
Dr. Michael Scofield, a scientist at MUSC, has been studying NAC for its brain-related effects. He found that NAC might help reduce both pain and cravings associated with drug use. This caught the attention of Dr. Sylvia Wilson, another researcher at MUSC who is focused on finding better ways to manage post-surgery pain without heavy reliance on opioids.
Together, they decided to test NAC on real patients to see how it could help after surgery.
The Study: NAC in Spinal Surgery
The team tested NAC in patients undergoing spinal surgery, a procedure known for causing significant post-operative pain. Some patients received NAC during surgery, while others received a simple saline solution as a placebo.
Over the next 48 hours, researchers monitored their pain levels and how much opioid medication they needed. The results were encouraging:
- Patients who received NAC used 19% fewer opioid doses than those who got the placebo.
- They reported less pain overall.
- They took longer to ask for pain relief, meaning their pain stayed under control for a longer time.
- These benefits continued even after NAC should have worn off, suggesting long-lasting effects.
This longer-lasting relief wasn’t unexpected. Dr. Scofield had already seen similar results in lab studies with addiction, where NAC appeared to continue helping even after the drug left the body. The hope is that this same long-term benefit can help people recovering from surgery.
What’s Next?
Encouraged by these early findings, the team is expanding their research. They’re now running a larger trial with patients undergoing minimally invasive hysterectomies, and more surgeries may be tested in the future. The goal is to prove that NAC can consistently and safely reduce pain and opioid use across different types of procedures.
But changes in standard medical practice require time and evidence. Dr. Wilson and her team are committed to building a strong case through careful, thorough research. If NAC continues to show benefits, it could become a widely used part of surgical care — offering pain relief without the downsides of traditional opioids.
Why It Matters
Post-surgical pain is a big challenge in medicine, and opioid addiction remains a serious public health crisis. A drug like NAC — already approved, widely available, and well understood — could offer a safer, easier option to help patients recover more comfortably.
For now, the researchers are hopeful and continuing their work. Their efforts could lead to a shift in how we treat pain after surgery, helping patients heal faster and more safely.
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